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HCPCS A9569
TC-99M AUTO WBC-DOSE - as described in hospitals' own price files.
9hospitals publishing a price
$4,160median cash price
$8,931median typical insurance price
| Hospital | Location | Cash price | Typical insurance | List price | Negotiated range |
|---|---|---|---|---|---|
| Flowers Hospital | Dothan, AL | $667 | $3,334 | $4,445 | $667 - $4,445 |
| Providence Centralia Hospital | Centralia, WA | $4,160 | - | $8,000 | - |
| Providence St. Peter Hospital | Olympia, WA | $4,160 | - | $8,000 | - |
| Providence Hood River Memorial Hospital | Hood River, OR | $6,000 | - | $8,000 | - |
| Providence St. Vincent Medical Center | Portland, OR | $6,000 | - | $8,000 | - |
| Mat-Su Regional Medical Center | Palmer, AK | $3,194 | $8,092 | $10,648 | $1,141 - $10,222 |
| Gadsden Regional Medical Center | Gadsden, AL | $1,534 | $8,931 | $12,786 | $1,525 - $12,786 |
| Grandview Medical Center | Birmingham, AL | $3,606 | $14,664 | $24,040 | $2,500 - $24,040 |
| Crestwood Medical Center | Huntsville, AL | $4,978 | $17,036 | $27,656 | $934 - $27,656 |
Prices are from each hospital's own machine-readable price file. Cash price is the published discounted cash price; typical insurance price is the median of the per-plan negotiated rates in the file; list price is the gross charge.
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